学術雑誌論文

学術雑誌論文

text

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2019, 27, p. 105

Impact of rewarming rate on the mortality of patients with accidental hypothermia: Analysis of data from the J-Point registry

BioMed Central Ltd.

英語

text

2019-11-26

https://doi.org/10.1186/s13049-019-0684-5

Watanabe, M., Matsuyama, T., Morita, S. et al. Impact of rewarming rate on the mortality of patients with accidental hypothermia: analysis of data from the J-Point registry. Scand J Trauma Resusc Emerg Med 27, 105 (2019). https://doi.org/10.1186/s13049-019-0684-5

Background: Accidental hypothermia (AH) is defined as an involuntary decrease in core body temperature to < 35 °C. The management of AH has been progressing over the last few decades, and numerous techniques for rewarming have been validated. However, little is known about the association between rewarming rate (RR) and mortality in patients with AH. Method: This was a multicentre chart review study of patients with AH visiting the emergency department of 12 institutions in Japan from April 2011 to March 2016 (Japanese accidental hypothermia network registry, J-Point registry). We retrospectively registered patients using the International Classification of Diseases, Tenth Revision code T68: 'hypothermia'. We excluded patients whose body temperatures were unknown or ≥ 35 °C, who could not be rewarmed, whose rewarmed temperature or rewarming time was unknown, those aged < 18 years, or who or whose family members had refused to join the registry. RR was calculated based on the body temperature on arrival at the hospital, time of arrival at the hospital, the documented temperature during rewarming, and time of the temperature documentation. RR was classified into the following five groups: ≥2.0 °C/h, 1.5-< 2.0 °C/h, 1.0-< 1.5 °C/h, 0.5-< 1.0 °C/h, and < 0.5 °C/h. The primary outcome of this study was in-hospital mortality. The association between RR and in-hospital mortality was evaluated using multivariate logistic regression analysis. Result: During the study, 572 patients were registered in the J-Point registry, and 481 patients were included in the analysis. The median body temperature on arrival to the hospital was 30.7 °C (interquartile range [IQR], 28.2 °C-32.4 °C), and the median RR was 0.85 °C/h (IQR, 0.53 °C/h-1.31 °C/h). The in-hospital mortality rates were 19.3% (11/57), 11.1% (4/36), 14.4% (15/104), 20.1% (35/175), and 34.9% (38/109) in the ≥2.0 °C/h, 1.5-< 2.0 °C/h, 1.0-< 1.5 °C/h, 0.5-< 1.0 °C/h, and < 0.5 °C/h groups, respectively. Multivariate regression analysis revealed that in-hospital mortality rate increased with each 0.5 °C/h decrease in RR (adjusted odds ratio, 1.49; 95% confidence interval, 1.15-1.94; P trend < 0.01). Conclusion: This study showed that slower RR is independently associated with in-hospital mortality.

© 2019 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License.

78379

Impact of rewarming rate on the mortality of patients with accidental hypothermia: Analysis of data from the J-Point registry

BioMed Central Ltd.

英語

2019-11-26

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

27

105

https://doi.org/10.1186/s13049-019-0684-5

31771645

https://hdl.handle.net/11094/78379